by
Sean Ruck, Contributing Editor | September 04, 2014
From the June 2014 issue of HealthCare Business News magazine
With software updates hitting the market rapid-fire and new companies cropping up with purported improvements on a monthly basis, undertaking the overhaul of an existing EMR system — or taking the plunge into EMR integration for the first time — can prove to be a daunting task. Ramya Krishnan, senior project engineer for the Health Devices Group at ECRI Institute discusses two key technical challenges — workflow and change management — and offers advice on how to overcome them.
1. Workflow — this addresses the issues of establishing the foundation for integration and properly training staff on what is required of them when working with the new system. Integration projects will typically change how clinicians document data, says Krishnan, and it’s important that the clinicians be on board for the integration to be a success. Therefore, it is extremely useful for hospitals to go over the existing workflow — identifying inefficiencies and figuring out ways that integration can improve workflow. There needs to be training to develop champions in each unit so that they will have a firm grasp of the process and in turn, they can help educate others.
For workflow, a couple of aspects can have a significant impact, according to Krishnan. The first is establishing patient context or ensuring patient data is matched with the right patient. The second is data validation, which is ensuring the data from that patient looks right.
Different devices have different options for establishing patient context and the clinician needs to have the proper information to associate the patient. “A typical device to look at is the spot check monitor,” says Krishnan. “A patient is checked and then that monitor is moved to the next patient. The device is typically moved frequently from one patient to another. In a non-integrated EMR world, you would go to the patient, take the vitals and write them down and enter it into the system later.”
Krishnan says the problem arises if the system isn’t properly disconnected from the EMR between patients. Therefore it is vital that staff knows when to establish and sever connections between the device and a particular patient’s record.
Most middle-ware systems can help to alleviate this problem. Many have hardware pieces that attach to or sit on top of the medical device — like a touch screen for instance, that helps identify the patient, pulls the information from the device and then transmits it to the EMR. Some facilities may instead have a workstation at the point-of-care that allows users to open up the software application to connect. Others may have a tab within their EMR flow sheet, but that would still require a workstation at the point-of-care to verify patient/data match.
